The Institute for Nursing Centers and the Alliance of Chicago propose to study the[unreadable] effectiveness of a partnership that shares resources, and utilizes a data-driven approach to[unreadable] promote full clinician use of an EHR in three nurse managed health centers and three[unreadable] community health centers in order to improve the quality of care in areas of preventive care,[unreadable] chronic disease management, and medication management for vulnerable populations. These[unreadable] partners have a track record of highly productive research, successful EHR implementation,[unreadable] commitment to data-supported high quality health care for vulnerable populations, and a history[unreadable] of building and maintaining strong collaborations.[unreadable] The goals of this project address one of the key problems in leveraging health IT to[unreadable] support high quality patient care: the fact that despite the promise, clinical decision support is[unreadable] often not used effectively or consistently by clinicians even when an EHR is available. The[unreadable] research design incorporates quantitative and qualitative methods as well as individual and[unreadable] center level analyses. The critical link between full EHR use (including clinical decision support[unreadable] features) and clinical performance and quality outcomes will be examined with rigorous[unreadable] quantitative methodology. Quality indicators chosen are those that the Institute of Medicine has[unreadable] identified as priority areas for improvement, and are also in areas where significant disparities[unreadable] across race, ethnic, and income groups exist. Qualitative methodology will add to the field?s[unreadable] understanding of health center leadership and change management required for successful use[unreadable] of EHR.